ABSTRACT
The application of artificial intelligence (AI) in hospitals yields many advantages but also confronts healthcare with ethical questions and challenges. While various disciplines have conducted specific research on the ethical considerations of AI in hospitals, the literature still requires a holistic overview. By conducting a systematic discourse approach highlighted by expert interviews with healthcare specialists, we identified the status quo of interdisciplinary research in academia on ethical considerations and dimensions of AI in hospitals. We found 15 fundamental manuscripts by constructing a citation network for the ethical discourse, and we extracted actionable principles and their relationships. We provide an agenda to guide academia, framed under the principles of biomedical ethics. We provide an understanding of the current ethical discourse of AI in clinical environments, identify where further research is pressingly needed, and discuss additional research questions that should be addressed. We also guide practitioners to acknowledge AI-related benefits in hospitals and to understand the related ethical concerns. Supplementary Information: The online version contains supplementary material available at 10.1007/s00146-021-01239-4.
ABSTRACT
BACKGROUND: The COVID-19 pandemic has not only changed the private lives of millions of people but has significantly affected the collaboration of medical specialists throughout health care systems worldwide. Hospitals are making changes to their regular operations to slow the spread of SARS-CoV-2 while ensuring the treatment of emergency patients. These substantial changes affect the typical work setting of clinicians and require the implementation of organizational arrangements. OBJECTIVE: In this study, we aim to increase our understanding of how digital transformation drives virtual collaboration among clinicians in hospitals in times of crisis, such as the COVID-19 pandemic. METHODS: We present the lessons learned from an exploratory case study in which we observed the introduction of an information technology (IT) system for enhancing collaboration among clinicians in a German hospital. The results are based on 16 semistructured interviews with physicians from various departments and disciplines; the interviews were generalized to better understand and interpret the meaning of the statements. RESULTS: Three key lessons and recommendations explain how digital transformation ensures goal-driven collaboration among clinicians. First, we found that implementing a disruptive change requires alignment of the mindsets of the stakeholders. Second, IT-enabled collaboration presupposes behavioral rules that must be followed. Third, transforming antiquated processes demands a suitable technological infrastructure. CONCLUSIONS: Digital transformation is being driven by the COVID-19 pandemic. However, the rapid introduction of IT-enabled collaboration reveals grievances concerning the digital dissemination of medical information along the patient treatment path. To avoid being caught unprepared by future crises, digital transformation must be further driven to ensure collaboration, and the diagnostic and therapeutic process must be opened to disruptive strategies.
